Caesarean Section Delivery

At the suggestion of your physician, it may be necessary for you to have a caesarean section delivery — also called C-section. A C-section is the surgical delivery of a baby. An incision is made in the mother's abdomen and uterus (womb) to deliver the baby. In the United States, 15 to 25 percent, or about one in five, of all births are delivered by cesarean section.

Reasons for the Procedure

Size of the babyIf a baby is very large, it might not be able to pass safely through the mother's pelvis.

Position of the placentaThe placenta (the organ that links the mother and the baby) sometimes blocks the path of exit from the uterus.

Multiple birthsCaesarean may be necessary if more than one baby is being born (such as the case with twins).

Failure of labor to progressSometimes labor (the sharp contractions that help push out the baby) might stop before the baby is born. The doctor might wait or give medication that helps labor start again. In some cases, the baby will still need to be delivered by caesarean.

Health of the babyIf the baby shows signs of distress such as a worsening abnormal heart rate during delivery, caesarean may be necessary.

Previous cesarean birthThe doctor may discuss with the mother that having delivered one baby by caesarean might mean it would be best to have other babies delivered by caesarean.

Fetal AnomaliesCertain problems with the fetus may have been diagnosed with prenatal testing.

During the Procedure

The doctor will make incisions in the abdomen and uterus and deliver the baby through the incisions. There are three different types of incisions:

Low transverse incisionsThese are the most common type. They are made sideways across the lower portion of the uterus. They usually bleed less than incisions made higher on the uterus, form stronger scars and present less danger of rupture during subsequent labors.

Classical incisionsThese incisions, also called high vertical incisions, were once used for all C-sections. Because this type of incision is associated with the highest risk of bleeding and of subsequent rupture of the uterus, it's now used only in emergency situations.

Low vertical incisionsThese types of incisions are similar to classical incisions, but are lower on the uterus where the uterine wall is thinner.

A low vertical incision may be used to deliver a baby situated in an awkward position, or when there's concern that the incision may need to be extended to become a classical incision.

The uterus will be closed with stitches that later dissolve on their own, and stitches or staples will be used to close the abdomen.

The entire procedure will take approximately 45 to 60 minutes to complete.

After the Procedure

The baby is immediately examined by medical personnel. Depending on your condition and the baby's condition, you may be allowed to bond by holding the baby, even while the surgeon is still sewing up the incision.

After the surgery, if you have an epidural in place, your surgeon may give you pain medication through the epidural tube to keep you comfortable. Otherwise, you'll receive pain medications through your IV and/or by mouth.

Depending on your recovery, you will remain in the hospital for two to four days.

You should heal quickly and completely after a c-section. For future deliveries, you may need to speak with your physician about the type of incision used, so that you'll know whether you can attempt a vaginal delivery in the future.

Breastfeeding moms may need some help learning to position and hold the baby in a manner that doesn't put pressure on your abdominal incision. You may also notice some uterine cramping, pain, and an increase in vaginal bleeding at the beginning of each nursing session.

Postoperative Care

You may require anti-nausea and pain medications.

For several days after surgery, you may need to eat a lighter, blander diet than usual.

You may be given special compression stockings to wear after surgery, to decrease the possibility of blood clots forming in your legs.

You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently, in order to improve lung function after general anesthesia.

You'll be encouraged to walk very soon after surgery.

You will experience heavy vaginal bleeding, as after any delivery, and will need to use an absorbent sanitary napkin.

Avoid lifting anything heavier than your baby for the first weeks after surgery.

Delay having sexual intercourse until you've had your six-week check-up.

Reasons to Call Your Doctor

If you have just had a caesarean section, call the doctor immediately if: